NPI | 1174930002 |
---|---|
Entity Type | Organization |
Authorized Contact | PALLAVI SINHA President 314-616-1377 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: MO 2004025287) |
Enumeration Date | 2014-07-11 |
Last Update Date | 2014-07-11 |